RESUMO
The imminent arrival of Medicare's Ambulatory Payment Classification (APC) system, HCFA's new outpatient prospective payment system (PPS), is expected to have as significant an effect on outpatient health care as the Diagnosis-Related Groups (DRG) system had on inpatient health care when it was launched in the early 1980s. Unlike the inauguration of the DRG system, however, the APC program is not expected to be as forgiving to organizations unprepared to implement the new prospective payment system. Since the APC program will be put into effect, HCFA says, "as soon as possible after January 1, 2000," healthcare financial managers should be preparing now.
Assuntos
Assistência Ambulatorial/classificação , Administração Financeira de Hospitais/métodos , Medicare/organização & administração , Ambulatório Hospitalar/economia , Sistema de Pagamento Prospectivo , Centers for Medicare and Medicaid Services, U.S. , Análise Custo-Benefício , Grupos Diagnósticos Relacionados/classificação , Grupos Diagnósticos Relacionados/economia , Eficiência Organizacional , Gestão da Informação , Revisão da Utilização de Seguros , Desenvolvimento de Pessoal , Estados UnidosRESUMO
The Health Care Financing Administration is expected to soon introduce a prospective payment method for reimbursement of hospital-based outpatient services provided to Medicare recipients. This payment system most likely will make use of an outpatient classification system based on ambulatory patient groups (APGs). Although the details of the new ambulatory payment system have not yet been finalized, healthcare facilities should start planning for implementation.
Assuntos
Assistência Ambulatorial/classificação , Grupos Diagnósticos Relacionados/economia , Ambulatório Hospitalar/economia , Sistema de Pagamento Prospectivo/tendências , Assistência Ambulatorial/economia , Centers for Medicare and Medicaid Services, U.S. , Custos Hospitalares , Medicare Part A , Estados UnidosRESUMO
This article will characterize the clinical classification systems which may be utilized in healthcare institutions by illustrating their use in data analysis and management, demonstrating current examples of reimbursement, and detailing recent research trends in clinical classification systems. The systems discussed are diagnosis related groups (DRGs), DRG systems adjusted for patient severity, and ambulatory patient groups (APGs).
Assuntos
Sistemas Computacionais , Grupos Diagnósticos Relacionados/classificação , Sistemas de Informação Hospitalar , Prontuários Médicos/classificação , Indexação e Redação de Resumos , Assistência Ambulatorial/classificação , Centers for Medicare and Medicaid Services, U.S. , Comorbidade , Humanos , Índice de Gravidade de Doença , Estados UnidosRESUMO
Necrotizing sialometaplasia of the palate, an enigmatic pseudomalignant penetrating ulcer, is a benign lesion which heals spontaneously in three to ten weeks. Relative painlessness contributes to patient delay in seeking medical attention, and suggest that many cases are subclinical. Clinically, the patient age group and morbid gross appearance mimic malignant palatal tumors. Lack of awareness of this entity has led to the misdiagnosis of carcinoma in several previous cases. However, the histopathologic features of sialadenitis, focal lobular necrosis with mucosal ulceration and glandular squamous metaplasia, are distinctly benign. A typical case and literature review are presented.
